Allergy affects up to a quarter of children in Western countries. This means that there are 4 to 8 allergic children at every classroom. Allergy may cause different symptoms, from very mild ones, such as occasional sneezing or nose rubbing, to very severe ones, such as asthma attacks or anaphylactic reactions that may pose a risk to the life of the child. In addition to the common problems that all children face at school, allergic children have specific problems due to their symptoms. Asthma may limit their physical activities and sports performance. Allergic children may be excluded from some activities “for the sake of” their health. Some children miss a lot of school days due to their disease, and so their academic performance may be impaired. This can also be affected by sleepiness induced by medication or poor sleep associated with allergy.

For some children, school can represent another risk for them. Children with severe food allergy have a high chance of suffering severe reactions and dramatic cases of death at school have occurred. The Pediatric Section of EAACI has been focusing on promoting a safe environment at school for allergic children. It is crucial that school personnel are educated to recognise and promptly treat allergic symptoms in children at high risk. These children need a personal management plan to help manage reactions. Self-injectable adrenaline devices are important but it may be necessary to deal with misconceptions about them. Teachers are not the only school personnel that need to be educated; other caregivers, trainers and canteen staff should be included. The prevention of allergic reactions is at least as important as their treatment. With good training, even the most allergic child can be safe in their school.

A broader range of professionals also need education about food allergy. For example cooks and staff at catering companies must be instructed about the preparation, handling and labelling of meals. This complements the joint effort of physicians, nurses, school personnel, parents, patients’ associations, and children themselves when they are mature enough. These efforts must be supported by a legal frame, currently lacking, to protect children on one side, and teachers on the other, when they follow medical instructions.

For further information, please access the European Academy of Allergy and Clinical position paper on the Management of the allergic child at school.

Dr Angel Mazon
Pediatric Allergist & EAACI Pediatric Section Webmaster